ABSTRACT
The syndrome of transient headache and neurologic deficits associated with cerebrospinal fluid lymphocytosis (HaNDL) is a benign and self limiting disorder characterized by 1 or more episodes of severe headache and transient neurologic deficits with lymphocytic pleocytosis in the cerebrospinal fluid. We report a case of a 30-year-old male who presented with four episodes of headache followed by hemi paresis and hemisensory loss in a week the patient was completely asymptomatic in between each episode of headache with neurological deficits. Persistent serial imaging to visualize the brain were normal with evidence of cerebrospinal fluid lymphocytosis, which lead to the diagnosis of HaNDL. We need to advocate a high degree of suspicion for HaNDL in the background of strong clinical history and findings, when imaging is normal.
ABSTRACT
Introduction: The Morbidity and mortality due to non-communicable diseases specially attributed to diabetes mellitus and coronary heart disease is raising rapidly in India, causing nearly 5.8 million deaths per year annually. Considering the strong association between the levels of serum uric acid and the occurrence of coronary atherosclerosis in subjects with type 2 diabetes mellitus, the current study has been undertaken to assess the factors influencing the serum uric acid levels in patients with type 2 diabetes mellitus Materials and methods: The study was an analytical cross sectional study, conducted in NRI Medical College and General Hospital, Guntur in Department of General Medicine and Department of Biochemistry, from December 2014 to November 2015. The study has included 70 cases diagnosed with Type 2 diabetes mellitus and 30 healthy controls. Hyperuricemia has been arbitrarily defined as >7.0 mg/dL in men and >6 mg/dL in women. Results: Among diabetic cases, the proportion of subjects with hyperuricemia was 11.43% and among the controls, none of the controls had hyperuricemia in study population. The mean uric acid level increased from 4.30 ± 0.77 in people with duration diabetes 2 to 4 years to 4.57±1.01 in people with duration of diabetes 5 to 8 years. Among people who had diabetes for 9 to 12 years, the mean uric acid level was 6.47 ± 1.07. The association between duration of diabetes and serum uric acid level was statistically significant. There was a strong positive association between hypertension, Hyperlipidemia and serum uric acid levels. Conclusions: Serum uric acid levels were significantly elevated in diabetic population. Elevated serum uric acid levels were significantly noted among those with dyslipidemia with high triglycerides, T. Murali Venkateswara Rao, Naga Karthik Vanukuri. A study on serum uric acid levels in type 2 diabetes mellitus and its association with cardiovascular risk factors. IAIM, 2016; 3(12): 148-155. Page 149 hypertension. Serum uric acid levels increased with increasing duration of diabetes.